Georgette Jungels' article in the November 2005 issue, “Maximizing Use of Medication in a Counseling Practice,” fails to mention what a four-page advertisement for Suboxone later in the issue makes clear. Suboxone is controlled as a Schedule III narcotic, “produces dependence of the opioid type,” and “can produce…changes in the level of consciousness that may interfere with patient evaluation.” In my opinion, this doesn't sound like a “miracle drug,” as Jungels calls it. It simply sounds like a drug.
Jungels speaks of “professionals with families” who can use Suboxone so that “no one needs to know they were addicted.” I would remind her that we are only as sick as our secrets. It has been my experience that whether the addict admits a problem or not, families already know on some level that something is horribly wrong. An admission by the addict that he/she suffers from the disease of addiction helps to clear away a considerable amount of confusion for the addict and the family. With such an admission, all involved can work toward their own solutions, rather than continuing to live in the problem.
I have heard many addicts say that the memory of their last withdrawal is part of what helps them remember why they want to be clean, never wanting to revisit that kind of suffering. Hearing Bob state in Jungels' article that Suboxone helped him get clean “without the trauma of withdrawal” led me to think that he might have missed out on something that could be valuable to his recovery: the pain that comes with hitting a “bottom.”
It sounds to me like this drug helps create an easier, softer way for the addict. The paradox is that the easier, softer way usually turns out to be neither.
12-Step fellowships have been effectively helping addicts recover since their inception nearly 70 years ago. Yet these are not mentioned until the second-to-last paragraph of the article (as well as being tacked on, almost as an afterthought, to a suggested treatment plan). When AA/NA are finally mentioned, it is to say that these will be a “big obstacle” and that “it will be important to educate” their members about this new treatment.
Perhaps those who would tout Suboxone as a “miracle drug” could stand a bit of education themselves. They might learn that the idea of substituting one drug with another has been attempted by addicts for decades, with terrible and often fatal consequences. I've known more than one addict whose heroin habit was substituted by a 20-plus-year methadone habit.
After reading the article and the ad, I conclude that Suboxone is simply methadone with a shoeshine. When I read that Jungels' treatment experience includes having worked in a methadone clinic, I could not have been less surprised.
Keith Berger, CBHT, Alternatives in Treatment, Inc., Boca Raton, Florida